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2019 LGA Roads and Works Conference - LGA Members Registration

* Mandatory Field

Participants details
Council Name*

**If you are not from a SA Council please select 'Other' and enter the "Other Organisation" field below

Other Organisation

**Please insert the name of your organisation

Address - Other Organisation

**Please insert your address if you are not from a SA Council

Participant Title*
Participant First Name*

**Please insert the first name of the participant

Participant Surname*

**Please insert the surname of the participant

Participant Position*

**Please insert the position title of the participant

Participant Email Address*

**Please insert the email address of the participant for direct contact

Do you have any special requirements (dietary or other)?*
If yes please provide details
Registration options
Full Conference Pass (both days and evening functions) - $550 + GST*
If you selected no for the full conference pass please select from the below options
Day 1 Pass (Thursday) - $210 + GST
Day 2 Pass (Friday) - $130 + GST
Pre Conference Reception Pass (Wednesday evening) - $130 + GST
Conference Dinner Pass (Thursday evening) - $150 + gst
Will you be staying for the BBQ lunch on day 2 at the close of the conference?*
Partner Registration
First and Last Name
Do you have any special requirements (dietary or other)?
If yes please provide details
Pre Conference Reception Pass (Wednesday evening) - $130 + GST
Conference Dinner Pass (Thursday evening) - $150 + GST
Bus Transfers

Complimentary Bus transfers will be offered to and from the Evening Functions on 14 & 15 August and from you accommodation.

The Pre Conference Reception will be held on Wednesday 14 August from 6pm at the Twenty Third Street Distillery.

The conference dinner will be held on Thursday 15 August from 6.30pm at the Renmark Club.

Please indicate below if you require transfers for the evening functions and the name and address of your accommodation so the correct information can be provided to the bus company.

Please note: the below fields are mandatory to complete if you do not require transfers please select no and put N/A in the accomodation fields.

Bus transfers Wednesday 14 August*
Bus Transfers Thursday 15 August*
Accomodation Name*
Accomodation Address*
Cancellation Policy and Payment
Cancellation Policy

All cancellations must be received in writing/email Friday 9 August or payment will be forfeited. If the registered participant is unable to attend the event, Councils are encouraged to send a substitute. Please confirm below that you have read this policy.

Tick below*
Payment

Payment is not required prior to the event. An invoice will be provide post event to the Council/Organsiation.

Purchase order number
Photography and videography consent

By registering for this Local Government Association event you accept the possibility that your photograph may be taken and/or you may be recorded. These images or recordings may be used or shared by the LGA for promotional and educational purposes.

If you do not wish to have your photo taken please contact marketing@lga.sa.gov.au.

If you see this, leave this form field blank.

Send a copy of the submitted form to this email address.

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